Indicator Assessment

Extreme temperatures and health

Indicator Assessment
Prod-ID: IND-189-en
  Also known as: CLIM 036
Published 20 Nov 2012 Last modified 11 May 2021
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  • Mortality and morbidity increase, especially in vulnerable population groups, and general population well-being decreases during extreme cold spells and heat waves, as well as above and below local and seasonal comfort temperatures, with different temperature thresholds in Europe.
  • The number of warm days and nights has increased across Europe in recent decades. Heat waves over the last decade have caused tens of thousands of premature deaths in Europe.
  • Length, frequency and intensity of heat waves are very likely to increase in the future. This increase can lead to a substantial increase in mortality over the next decades, especially in vulnerable groups, unless adaptation measures are taken.
  • Cold-related mortality is projected to decrease in Europe due to climate change as well as better social, economic and housing conditions in many countries.

Temperature-mortality relationship in 15 European cities

Note: Figure shows relationship between daily maximum apparent temperature (Barcelona: mean apparent temperature) and natural mortality (blue) and 95% confidence interval (grey).

Data source:

Baccini M.; Biggeri, A.; Accetta, G.; Kosatsky, T.; Katsouyanni, K.; Analitis, A.; Ross Anderson, H.; Bisanti, L.; D'Ippoliti, D.; Danova, J.; Forsberg, B.; Medina, S.; Paldy, A.; Rabczenko, D.; Schindler, C. and Michelozzi, P., 2008. Effects of apparent temperature on summer mortality in 15 European cities: results of the PHEWE project. Epidemiology 19 (5).

Past trends

The summer of 2003 was an outstanding example of increased mortality during periods of extreme temperatures, with an estimated premature mortality of 70 000 people[i]. During the summers of 2006, 2007 and 2010 temperature records were again broken in different parts of Europe[ii].


Future climate change is very likely to increase frequency, intensity and duration of heat waves, which leads to a marked increase in heat-attributable deaths under future warming[iii] (Figure 1). Synergistic effects between high temperature and air pollution (PM10 and ozone) were observed during hot weather. Long warm and dry periods in combination with other factors can also lead to forest fires, which can also have severe health impacts[iv].

Projections of heat-related mortality use evidence from epidemiological studies combined with future scenarios of climate, population and acclimatisation with regionally specific temperature-mortality relationships[v]. The PESETA project estimates that heat-related mortality in Europe in the 2080s will increase by between 60 000 and 165 000 (without adaptation and physiological acclimatisation, compared to the present baseline). Cold-related mortality is projected to decrease by between 60 000 and 250 000, which is about the same magnitude as the increase from heat-related mortality[vi]. Uncertainty in these estimates needs to be carefully addressed[vii]. A study covering most of Europe projects a progressive change in the seasonality of maximum monthly mortality from winter to summer, an increase in the frequency of warm extremes and that the number of uncomfortable days will increase. In the absence of adaptation, these changes would lead to a reduction in human lifespan of up to 3–4 months in 2070–2100.

The ClimateCost project estimates an additional 26 000 deaths per year from heat by the 2020s (2011–2040), rising to 127 000 deaths per year by the 2080s (2071–2100) under a medium to high emission (A1B) scenario, assuming no adaptation. While heat-related mortality is projected to increase across Europe, impacts would be highest in southern Europe. Under an E1 scenario, broadly equivalent with stabilising global mean temperature increase at 2 °C above pre-industrial levels, impacts are reduced significantly, with an estimated 69 000 deaths per year by the 2080s. With acclimatisation, the estimated number of heat-related deaths declines substantially to 13 000 per year in the 2020s, and 40 000 per year in the 2080s under the A1B scenario; for the E1 scenario it is down to 18 000 per year in the 2080s. Similar to PESETA, these figures are subject to considerable uncertainties.

[i] Jean-Marie Robine et al., „Death toll exceeded 70,000 in Europe during the summer of 2003“, Comptes rendus biologies 331, Nr. 2 (Februar 2008): 171–178, doi:10.1016/j.crvi.2007.12.001.

[ii] D. Barriopedro et al., „The hot summer of 2010: Redrawing the temperature record map of Europe“, Science 332, Nr. 6026 (März 17, 2011): 220–224, doi:10.1126/science.1201224.

[iii] M Baccini et al., „Impact of heat on mortality in 15 European cities: attributable deaths under different weather scenarios“, Journal of Epidemiology and Community Health 65, Nr. 1 (Januar 2011): 64–70, doi:10.1136/jech.2008.085639.

[iv] A. Analitis, I. Georgiadis, and K. Katsouyanni, „Forest Fires Are Associated with Elevated Mortality in a Dense Urban Setting“, Occupational and Environmental Medicine 69, Nr. 3 (Januar 3, 2012): 158–162, doi:10.1136/oem.2010.064238.

[v] Baccini et al., „Impact of heat on mortality in 15 European cities“.

[vi] J.C. Ciscar et al., „Physical and economic consequences of climate change in Europe“, Proceedings of the National Academy of Sciences 108, Nr. 7 (Januar 31, 2011): 2678–2683, doi:10.1073/pnas.1011612108; Cunrui Huang et al., „Projecting future heat-related mortality under climate change scenarios: A systematic review“, Environmental Health Perspectives 119, Nr. 12 (August 4, 2011): 1681–1690, doi:10.1289/ehp.1103456.

[vii] Paul Watkiss and Alistair Hunt, „Projection of economic impacts of climate change in sectors of Europe based on bottom up analysis: human health“, Climatic Change 112, Nr. 1 (2012): 101–126, doi:10.1007/s10584-011-0342-z.

Supporting information

Indicator definition

  • Daily mortality rates in 15 European cities by apparent temperature in summer time


  • Logarithm of mortality rate


Policy context and targets

Context description

In April 2013 the European Commission presented the EU Adaptation Strategy Package ( This package consists of the EU Strategy on adaptation to climate change /* COM/2013/0216 final */ and a number of supporting documents. One of the objectives of the EU Adaptation Strategy is Better informed decision-making, which should occur through Bridging the knowledge gap and Further developing Climate-ADAPT as the ‘one-stop shop’ for adaptation information in Europe. Further objectives include Promoting action by Member States and Climate-proofing EU action: promoting adaptation in key vulnerable sectors. Many EU Member States have already taken action, such as by adopting national adaptation strategies, and several have also prepared action plans on climate change adaptation.

The European Commission and the European Environment Agency have developed the European Climate Adaptation Platform (Climate-ADAPT, to share knowledge on observed and projected climate change and its impacts on environmental and social systems and on human health; on relevant research; on EU, national and subnational adaptation strategies and plans; and on adaptation case studies.


No targets have been specified.

Related policy documents

  • Climate-ADAPT: Adaptation in EU policy sectors
    Overview of EU sector policies in which mainstreaming of adaptation to climate change is ongoing or explored
  • Climate-ADAPT: Country profiles
    Overview of activities of EEA member countries in preparing, developing and implementing adaptation strategies
  • DG CLIMA: Adaptation to climate change
    Adaptation means anticipating the adverse effects of climate change and taking appropriate action to prevent or minimise the damage they can cause, or taking advantage of opportunities that may arise. It has been shown that well planned, early adaptation action saves money and lives in the future. This web portal provides information on all adaptation activities of the European Commission.
  • EU Adaptation Strategy Package
    In April 2013, the European Commission adopted an EU strategy on adaptation to climate change, which has been welcomed by the EU Member States. The strategy aims to make Europe more climate-resilient. By taking a coherent approach and providing for improved coordination, it enhances the preparedness and capacity of all governance levels to respond to the impacts of climate change.


Methodology for indicator calculation

City-specific estimates of the relevant parameters were obtained from 15 years (1990-2004) of data by specifying a marginal Poisson model for the daily count of deaths.

Methodology for gap filling

Not applicable

Methodology references

  • Baccini et al. (2008): Heat effects on mortality in 15 European cities Baccini, M., Biggeri, A., Accetta, G., Kosatsky, T., Katsouyanni, K., Analitis, A., Anderson, H. R., Bisanti, L., D'Ippoliti, D., Danova, J., Forsberg, B., Medina, S., Paldy, A., Rabczenko, D., Schindler, C. et al. (2008) Heat effects on mortality in 15 European cities. Epidemiology 19(5), 711–719.


Methodology uncertainty

Not applicable

Data sets uncertainty

Attribution of health effects to climate change is difficult due to the complexity of interactions, and potentially modifying effects of a range of other factors (such as land use changes, public health preparedness, and socio-economic conditions). Criteria for defining a climate-sensitive health impact are not always well identified and their detection sometimes relies on complex statistical or modelling studies (e.g. health impacts of heat waves). Furthermore, these criteria as well as the completeness and reliability of observations may differ between regions and/or institutions, and they may change over time. Data availability and quality is crucial in climate change and human health assessments, both for longer term changes in climate-sensitive health outcomes, and for health impacts of extreme events. The monitoring of climate-sensitive health effects is currently fragmentary and heterogeneous. All these factors make it difficult to identify significant trends in climate-sensitive health outcomes over time, and to compare them across regions. In the absence of reliable time series, more complex approaches are often used to assess the past, current or future impacts of climate change on human health.

Further information on uncertainties is provided in Section 1.7 of the EEA report on Climate change, impacts, and vulnerability in Europe 2012 (

Rationale uncertainty

No uncertainty has been specified

Data sources

Other info

DPSIR: Impact
Typology: Descriptive indicator (Type A - What is happening to the environment and to humans?)
Indicator codes
  • CLIM 036
Frequency of updates
Updates are scheduled every 4 years
EEA Contact Info


Geographic coverage

Temporal coverage